Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Background: To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods: Two h...

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Detalles Bibliográficos
Autores: Vilaseca González, Isabel, Avilés Jurado, Francesc Xavier, Valduvieco, Izaskun, Berenguer, Joan, Grau, Juan José, Baste, Neus, Muxí Pradas, África, Castillo, Paola, Lehrer, Eduardo, Jordana, Marta, Ramírez Ruiz, Rosa Delia, Costa, José Miguel, Oleaga Zufiría, Laura, Bernal Sprekelsen, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/195211
Acceso en línea:https://hdl.handle.net/2445/195211
Access Level:acceso abierto
Palabra clave:Càncer de laringe
Microcirurgia
Làsers en cirurgia
Cartílag
Teixit connectiu
Larynx cancer
Microsurgery
Lasers in surgery
Cartilage
Connective tissue
Descripción
Sumario:To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Background: To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods: Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results: The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085-0.979]) and anterior (HR = 0.278 [0.128-0.605]) and posterior (HR = 0.269 [0.115-0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537-8.495]) and posterior (HR = 5.195 [2.167-12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS. Conclusions: Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS.

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